Bottom Line:
There was no significant difference between the two groups with respect to postoperative pain and nausea.On Day 4 (but not on Days 1 and 7 postoperatively) patients in the No-MBP group perceived more discomfort than patients in the MBP group, p = 0.02.Time to intake of fluid and solid food did not differ between the two groups.

Affiliation: University of Umeå and Department of Surgery, Visby Hospital, Visby Sweden. barbel.jung@hsf.gotland.se

ABSTRACT

Background: Preoperative mechanical bowel preparation can be questioned as standard procedure in colon surgery, based on the result from several randomised trials.

Methods: As part of a large multicenter trial, 105 patients planned for elective colon surgery for cancer, adenoma, or diverticulitis in three hospitals were asked to complete a questionnaire regarding perceived health including experience with bowel preparation. There were 39 questions, each having 3 - 10 answer alternatives, dealing with food intake, pain, discomfort, nausea/vomiting, gas distension, anxiety, tiredness, need of assistance with bowel preparation, and willingness to undergo the procedure again if necessary.

Results: 60 patients received mechanical bowel preparation (MBP) and 45 patients did not (No-MBP). In the MBP group 52% needed assistance with bowel preparation and 30% would consider undergoing the same preoperative procedure again. In the No-MBP group 65 % of the patients were positive to no bowel preparation. There was no significant difference between the two groups with respect to postoperative pain and nausea. On Day 4 (but not on Days 1 and 7 postoperatively) patients in the No-MBP group perceived more discomfort than patients in the MBP group, p = 0.02. Time to intake of fluid and solid food did not differ between the two groups. Bowel emptying occurred significantly earlier in the No-MBP group than in the MBP group, p = 0.03.

Conclusion: Mechanical bowel preparation is distressing for the patient and associated with a prolonged time to first bowel emptying.

Mentions:
Only three statistically significant differences were noted between the two groups (Table 1, 2): willingness to consider the same preoperative procedure again time to first bowel movement (p = 0.04) and degree of discomfort on day 4 postoperatively (p = 0.02). The response rate in the No-MBP group to the question about the willingness to consider the same preoperative procedure again was low (58%) compared to the response rate in the MBP group (95%) (P < 0.001), see Table 4. Patients in the No-MBP group had their first bowel movement earlier than patients in the MBP group, see Table 5. Patients in the No-MBP group experienced a higher degree of discomfort (but not pain or nausea) on the fourth postoperative day compared to patients in the MBP group. For details see Figures 123.

Mentions:
Only three statistically significant differences were noted between the two groups (Table 1, 2): willingness to consider the same preoperative procedure again time to first bowel movement (p = 0.04) and degree of discomfort on day 4 postoperatively (p = 0.02). The response rate in the No-MBP group to the question about the willingness to consider the same preoperative procedure again was low (58%) compared to the response rate in the MBP group (95%) (P < 0.001), see Table 4. Patients in the No-MBP group had their first bowel movement earlier than patients in the MBP group, see Table 5. Patients in the No-MBP group experienced a higher degree of discomfort (but not pain or nausea) on the fourth postoperative day compared to patients in the MBP group. For details see Figures 123.

Bottom Line:
There was no significant difference between the two groups with respect to postoperative pain and nausea.On Day 4 (but not on Days 1 and 7 postoperatively) patients in the No-MBP group perceived more discomfort than patients in the MBP group, p = 0.02.Time to intake of fluid and solid food did not differ between the two groups.

Affiliation:
University of Umeå and Department of Surgery, Visby Hospital, Visby Sweden. barbel.jung@hsf.gotland.se

ABSTRACT

Background: Preoperative mechanical bowel preparation can be questioned as standard procedure in colon surgery, based on the result from several randomised trials.

Methods: As part of a large multicenter trial, 105 patients planned for elective colon surgery for cancer, adenoma, or diverticulitis in three hospitals were asked to complete a questionnaire regarding perceived health including experience with bowel preparation. There were 39 questions, each having 3 - 10 answer alternatives, dealing with food intake, pain, discomfort, nausea/vomiting, gas distension, anxiety, tiredness, need of assistance with bowel preparation, and willingness to undergo the procedure again if necessary.

Results: 60 patients received mechanical bowel preparation (MBP) and 45 patients did not (No-MBP). In the MBP group 52% needed assistance with bowel preparation and 30% would consider undergoing the same preoperative procedure again. In the No-MBP group 65 % of the patients were positive to no bowel preparation. There was no significant difference between the two groups with respect to postoperative pain and nausea. On Day 4 (but not on Days 1 and 7 postoperatively) patients in the No-MBP group perceived more discomfort than patients in the MBP group, p = 0.02. Time to intake of fluid and solid food did not differ between the two groups. Bowel emptying occurred significantly earlier in the No-MBP group than in the MBP group, p = 0.03.

Conclusion: Mechanical bowel preparation is distressing for the patient and associated with a prolonged time to first bowel emptying.